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Individual
SHANEZ T JENKINS
Active
Individual
SHANEZ T JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
19036
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
346646
MHN
MD
01
—
517251
OPTUM
MD
05
—
609500300
—
MD
05
—
609550002
—
MD
01
—
R968
CAREFIRST BCBS OF MD
MD
Enumeration date
08/18/2011
Last updated
07/18/2016
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